Treatment of Sex Offenders

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J. Tabachnick et al.
The CDC describes a public health approach to prevention through three prevention
categories based upon when the intervention occurs (Centers for Disease
Control and Prevention, 2004 ). These levels include:
• Primary prevention: Approaches that take place before sexual violence has
occurred in order to prevent initial perpetration or victimization
• Secondary prevention: An immediate response after sexual violence has occurred
to deal with the short-term consequences of violence
• Tertiary prevention: A long-term response that follows sexual violence, designed
to deal with the lasting consequences of violence and provide treatment to
perpetrators
The aim of these levels is to effectively position the appropriate interventions to
prevent harmful behavior and the subsequent negative consequences. In regard to
sexual violence prevention, the core aim of these three levels is to stop offending
and reduce the impact of sexual violence (Laws, 2000 ; McCartan et al., 2015 ;
Smallbone et al., 2008 ).
The social-ecological model (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002 ) is
orientated around four levels of intervention: individuals, relationships, communities,
and society. Prevention programs that address all four levels are more likely to
successfully change the targeted behavior(s). This social-ecological model expands
prevention efforts beyond typical education and individual self-help or treatment
models to describe a broader range of activities. Those who use this model argue
that to address complex public health problems, no single solution will work.
Rather, multiple interventions need to be targeted at each of these levels. In fact, the
authors suggest that prevention programs that address all four levels are more likely
to change the targeted behavior(s).
Combining these two public health frameworks (see Table 14.1 ) would mean
that prevention strategies would need to: (1) target behaviors before they are perpetrated
as well as interventions targeting sexually abusive behavior after it is perpetrated
combined with (2) interventions that target all the four levels of the
social- ecological model to be successful in reducing sexually abusive behaviors.
Taken together, these strategies encompass a large spectrum of sexual violence
interventions stretching from healthy sexuality educational curricula for adoles-
Table 14.1 Suggested framework for preventing the perpetration of sexual violence
Before
After
Individual/relationship
Healthy sexuality education
(e.g., bystander interventions such as
Green Dot and Bringing in the Bystanders)
and programs targeting at risk individuals
(e.g., Project Dunkelfeld)
Programs for those who have harmed or
been harmed (e.g., treatment) as well as the
criminal justice system to prosecute those
who have abused
Community/society
Programs targeting at risk populations
(e.g., Safe Dates program, Shifting
Boundaries, growing number of
consent laws, child safety policies
within youth serving organizations)
Policies and programs responding
to sexual violence and targeting
sex offenders in the community
(e.g., sex offender management laws,
Circles of Support and Accountability)